She weighed just 7 kgs and was suffering from a life-threatening disease. Parvathy MS from Kodakara, Thirissur ( Kerala) suffering from a rare congenital condition called primary hyperoaxaluria-type 1 in which the deficiency of a liver enzyme leads to an abnormal spike in blood oxalate levels that permanently damage the kidneys.
Parvathy was put on peritoneal dialysis when she was just 4 months old—the dialysis lasting for 20 hours each day.After a year she had to be put on a ventilator and needed daily haemodialysis. Soon the doctors had to resort to the last option to save her life. She successfully underwent a dual live-donor transplant—her father donated his liver and grandmother, a kidney- making her the smallest child in the world to have successfully undergone a dual live-donor transplant.
The transplant team at Aster Medcity, Kochi created history by performing the surgery.She was put on an intense nutritional rehabilitation programme to attain a pre-transplant weight of 10 kilograms, along with dialysis. She was then put on peritoneal dialysis and later hemodialysis, with the support of blood pressure regulators. However, she stopped gaining weight due to multiple complications.
Seeing her condition worsen by the day, doctors decided to go ahead with the surgery in spite of the very high risk. The main challenge was her weight and size as children less than 10 kilograms will not have adequate space to accept an adult kidney. And if a disproportionately large kidney is transplanted, there will be compression in the kidney veins, which in turn will lead to clots in the transplanted kidney.
“The solution was to remove her damaged right kidney and use the space vacated by her liver to place the new kidney. The blood volume in her kidney too had to be increased using highly specialised perioperative anaesthetic techniques”, said Dr. Mathew Jacob, Consultant Liver & Abdominal Multi-Organ Transplant Surgeon.
After two weeks of extensive planning and preparations, the 20-hour transplant procedure comprising three simultaneous surgeries – liver donor, kidney donor and recipient- was successfully was carried out by a team of surgeons led by Dr. Mathew Jacob and six anaesthetists led by Dr. Suresh G Nair.
Post surgery, Parvathy had to stay in the hospital for 51 days. She recovered well and started gaining weight. Her pre and postoperative care was handled by Dr. Rajappan Pillai, Consultant Paediatric Intensivist.
“Parvathy’s case is testimony to that the fact that we can achieve what we think is unachievable. Our team has pushed the boundaries of possibility, challenged adversities and created history”, said Dr. Harish Pillai, CEO – Aster Medcity & Cluster Head (Kerala) – Aster DM Healthcare.